Glomus tumor of the finger

Case contributed by Dr Domenico Nicoletti

Presentation

Thumb subungal mass with painful and bluish discoloration.

Patient Data

Age: 35 years
Gender: Female
MRI

In the subungual area of the terminal phalanx of the thumb there’s a little solid nodule with regular margins, hypointense on T1-, hyperintense on T2-weighted image, with homogeneous contrast uptake. There is no erosion of the bone cortex.

Surgery

Transungual resection was performed to remove tumor.

Histological report

Circumscribed tumor with cords, nests of glomus cells surrounding intricate vascular network. Cuboidal monomorphic glomus cells with round nuclei. Intervening stroma is edematous, myxoid, and shows numerous mast cells.

Case Discussion

Glomus tumor is a benign tumor that originates in the glomus, which is an arterio-venous shunt involved in body temperature regulation. Glomus tumor is typically characterized with triad: intermittent pain, tenderness and the pain is reproduced when the lesion is placed in the cold water. Most glomus tumors are benign. On MR imaging glomus tumor is isointense on T1- and hyper-intense on T2-weighted images, with homogenous enhancement after contrast.

Radiographer: TSRM Fabio Imola

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